The Value of Thoracic Lavage in the Treatment of Anastomotic Leakage After Surgery for Type III Esophageal Atresia

Xu Cui, Yuanbin He, Liu Chen, Yu Lin, Jianqin Zhang, Chaoming Zhou, Xu Cui, Yuanbin He, Liu Chen, Yu Lin, Jianqin Zhang, Chaoming Zhou

Abstract

BACKGROUND The aim of this study was to define whether the addition of thoracic lavage to chest drainage was more efficient than the use of chest drainage alone in the treatment for anastomotic leaks in type III esophageal atresia. MATERIAL AND METHODS The clinical data of 42 patients with anastomotic leakage treated with the addition of thoracic lavage from January 2012 to March 2019 in our hospital were analyzed retrospectively. The clinical data of 50 patients with anastomotic leakage treated without thoracic lavage from March 1999 to December 2011 in our hospital were selected as controls. RESULTS The duration of fistula healing, mechanical ventilation, hospitalization in intensive care unit, and gastric tube intubation in the thoracic lavage group were significantly shorter than those in the non-lavage group. The cost of hospitalization and the incidence of severe pneumonia were significantly lower in the thoracic lavage group than in the non-lavage group. The diameter of the anastomotic opening after anastomotic fistula healing was wider in the thoracic lavage group than in the non-lavage group. CONCLUSIONS The technique of thoracic lavage is simple, economical and convenient and can effectively promote the healing of anastomotic fistulas, accelerate postoperative recovery in children and reduce the cost of treatment.

Conflict of interest statement

Conflict of interests

None.

References

    1. Pinheiro PF, Simõese Silva AC, Pereira RM. Current knowledge on esophagealatresia. World J Gastroenterol. 2012;18:3662–72.
    1. Sulkowski JP, Cooper JN, Lopez JJ, et al. Morbidity and mortality in patients with esophageal atresia. Surgery. 2014;156:483–91.
    1. Nice T, Tuanama Diaz B, Shroyer M, et al. Risk factors for stricture formation after esophageal atresia repair. J Laparoendosc Adv Surg Tech A. 2016;26:393–98.
    1. Gross RE. Atresia of the esophagus. Am J Dis Child. 1947;74:369.
    1. Chittmittrapap S, Spitz L, Kiely EM, et al. Anastomotic leakage following surgery for esophageal atresia. J Pediatr Surg. 1992;27:29–32.
    1. Spitz L. Esophageal atresia lessons I have learned in a 40-year experience. J Pediatr Surg. 2006;41:1635–40.
    1. Zhao R, Li K, Shen C, et al. The outcome of conservative treatment for anastomotic leakage after surgical repair of esophageal atresia. J Pediatr Surg. 2011;46:2274–78.
    1. Spitz L. Oesophageal atresia. Orphanet J Rare Dis. 2007;2:24.
    1. Zhao R, Zheng S, Shen C. [Clinical analysis of anastomotic leakage after type III esophageal atresia surgery]. Chinese Journal of Pediatric Surgery. 2008;29:707–10. [in Chinese]
    1. Heffelfinger JD, Davis TE, Gebrian B, et al. Evaluation of children with recurrent pneumonia diagnosed by World Health Organization criteria. Pediatr Infect Dis J. 2002;21:108–12.
    1. Zhao R, Li K, Shen C, et al. The outcome of conservative treatment for anastomotic leakage after surgical repair of esophageal atresia. J Pediatr Surg. 2011;46:2274–78.
    1. Liyang Y, Zhan G, Zewei Z, et al. Use of pericardium to repair anastomotic leak after esophageal atresia surgery; experience with one case. Turk Pediatri Ars. 2017;52(1):43–45.
    1. Zheng S. [Prevention and management of short-term or long-term complications after congenital esophageal atresia]. Journal of Clinical Surgery. 2010;18:512–13. [in Chinese]
    1. McCallion WA, Hannon RJ, Boston VE. Prophylactic extrapleural chest drainage following repair of esophageal atresia: Is it necessary? J Pediatr Surg. 1992;27:561.
    1. Koivusalo AI, Pakarinen MP, Lindahl HG, et al. Revisional surgery for recurrent tracheoesophageal fistula and anastomotic complications after repair of esophageal atresia in 258 infants. J Pediatr Surg. 2015;50:250–54.
    1. Friedmacher F, Kroneis B, Huber-Zeyringer A, et al. Postoperative complications and functional outcome after esophageal atresia repair: Results from longitudinal single-center follow-up. J Gastrointest Surg. 2017;21:927–35.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe